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Over the past 12 years, I have been involved in co-ordinating and co-facilitating horticulture therapy groups for school-aged children in Liverpool. The work has involved the local child and

adolescent mental health service (CAMHS) and the University of Liverpool in not only running these groups but also researching the effectiveness of horticulture on mental health and

wellbeing in both traditional and non-traditional ways. Over the time of the groups, we have used standardised questionnaires, such as strengths and difficulties (SDQ), wellbeing measures

such as Edinburgh Warwick Well Being Check Cards, and also some more novel ways (such as photo capture, drawing and writing journals) and the five ways to wellbeing. During this time, we

have found that some are useful and meaningful, while others are less so, in particular, in measuring what impact horticulture and nature has on children’s health and wellbeing  The group we

run meets weekly at school and we have access to a protected garden/nature space, which is important in that it is not disturbed by others from week to week. Each group has a similar format

whereby the children involved are encouraged to explore, investigate, problem solve, come up with ideas and work either together or on their own. The benefits of being and working in nature

and gardens is well documented in terms of physical health benefits, which include weight management, reduced blood pressure, and cardiovascular benefits. It can also aid socialisation and

decrease isolation, but less is recorded on the mental health and wellbeing benefits – certainly even less so with children and young people. During our work, we have tried to find a way to

measure these benefits that best fit and have found that using photo capture, and recording what the photo meant in terms of the five ways to wellbeing, has been extremely useful in

monitoring how nature and horticulture have changed the way young people see these aspects. The five ways to wellbeing was developed by the New Economics Foundation as a way to record and

note ways to maintain and enhance wellbeing. These aspects are ‘connect’, ‘give’, ‘be active’, ‘take notice’, and ‘learn’. During the running of each group, we ask in what ways you have

noticed the five ways to wellbeing or have been aware of them in the session. They also attribute photographs taken with multimedia devices to the five ways and record them in a meaningful

way. > “Feedback from the children and the school staff has been > overwhelmingly positive” We have found the children in primary schools find this method easy to use and a positive

experience, which has highlighted the importance of finding methods that are appropriate for them to use.  Some of the interesting comments about what the children have noted in respect of

the five ways have included several themes.  Feedback from the children and the school staff has been overwhelmingly positive, with improvements in behaviour, attendance, and social

interaction noted by teachers and the children reporting feeling calmer, learning to get on with others, noticing nature and wanting to do more in nature in terms of taking care of plants,

wanting to share their space with others or taking home some of the fruits of their labours. Doing things in the nature way can have a positive impact on the mental health and wellbeing of

children. Finding creative and novel methods to measure change is important in that the data collected is meaningful to the children – we shared the outcomes with them as well as their

parents and to clinicians who measure outcomes. _Carl Dutton is a mental health practitioner for FRESH CAMHS at Alderhey Children’s NHS Foundation Trust. He coordinates the Haven of

greenspace project in schools in Liverpool and is a mental health nurse and psychodrama psychotherapist. He has presented and written about his work using horticulture nationally and

internationally._